Individual
MS. AMY M NUTTBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
101 E 8TH ST STE 110, VANCOUVER, WA 98660-3294
(360) 602-6842
Mailing address
1014 MAIN STREET, VANCOUVER, WA 98660
(360) 695-1014
(360) 750-1374
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
60926883
WA
1041C0700X
Clinical Social Worker
L7835
OR
1041C0700X
Clinical Social Worker
LCSW79663
CA
Other
Enumeration date
06/11/2013
Last updated
09/30/2019
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